特发性室性心律失常患者的心率变异性  

The heart rate variability of patients with idiopathic ventricular arrhythmias

作　　者：陈惠平[1] 肖峰[1] 李小荣[1] 郑雅云 曹克将[1] 

机构地区：[1]南京医科大学第一附属医院,江苏南京210029

出　　处：《中国心脏起搏与心电生理杂志》2015年第4期324-326,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：国家"十二五"科技支撑计划项目(No:2011BAI11B13)

摘　　要：目的探讨自主神经系统在特发性室性心律失常(IVA)发生机制中的作用。方法入选组:IVA组(n=97)和对照组(n=114例);根据电生理标测和导管消融结果将IVA组又按起源不同分为右室(RV)组(n=57)和左室(LV)组(n=40)。HRV的检测与分析建立在24 h动态心电图记录基础上,HRV分析指标包括:1时域指标:正常窦性RR间期的总体标准差(SDNN)、每5 min窦性RR间期均值标准差(SDANN)、正常连续窦性RR间期差值均方根(RMSSD)和相邻RR间期差值>50 ms百分比(PNN50);2频域指标:低频谱功率(LF)、高频谱功率(HF)、低频/高频谱功率比值(LF/HF)。结果 IVA组与对照组相比较,SDNN、SDANN、RMSSD、PNN50、Ln LF及LF/HF均低于对照组。RV组与LV组相比较,RV组的SDNN与SDANN低于LV组,而LF/HF则高于LV组。结论 HRV在正常人与IVA患者之间以及左、右室不同起源的IVA患者之间存在差异性,提示自主神经系统可能参与了IVA的发生。Objective To explore the automatic nervous system （ANS） role in the pathogenesis of idiopathic ventricu- lar arrhythmias （IVA）. Methods Chosen groups： The IVA group （n=97） and the control group （n= 114） ; the IVA group was divided into right ventricular （RV） group （n = 57 ） and left ventricular （LV） group （n = 40） according to the results of electrophysiological mapping and catheter ablation. Examination and analysis of HRV was built on the basis of 24- hour ambulatory electrocardiogram （Holter） recordings, HRV analysis indexes： （~）time-domain indexes： standard deviation of normal number of intervals （SDNN） , standard deviation per 5 min averages normal number of intervals （ SDANN）, root means square of the standard deviation between adjacent normal number of intervals （ RMSSD）, and percentage of NNSO in the total number of NN intervals （PNNSO） ; （~）frequency-domain indexes： low frequency （ LF）, high frequency （HF） and the ratio of LF to HF （LF/HF）. Results Compared to the control group, SDNN, SDANN, RMSSD, PNNSO, LnLF and LF/HF of the IVA group were lower. Similarly, compared to the LV group, SDNN and SDANN of the RV group were lower. Nevertheless, LF/HF of the RV group was higher than the LV group. Conclusion HRV differences exist be- tween healthy person and IVA patients, as well as different origins of the left and right chambers in IVA patients, sugges- ting that the autonomic nervous system may play roles in the occurrence of IVA.

关 键 词：心血管病学 特发性室性心律失常 自主神经系统 心率变异性 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]